Article

Our objective was to explore the relationship between low vitamin D, secondary
hyperparathyroidism, and heterotopic ossification (HO) in patients with spinal
cord injury (SCI). Ninety-six subjects with acute or chronic motor complete SCI
participated. Levels of serum vitamin D25(OH), calcium, and intact parathyroid
hormone (PTH) were collected, and information regarding nutritional patterns and
fracture history was obtained from subjects. Evidence of current or previous HO
was ascertained through chart review. Of the 96 subjects, 12 were found to have
developed HO, 11 with serum vitamin D25(OH) between 5 and 17 ng/mL. Nine subjects
exhibited secondary hyperparathyroidism in the range of 72 to 169 pg/mL. Only one
subject demonstrated HO in the absence of low vitamin D. However, many subjects
with low vitamin D (5-31 ng/mL) did not have hyperparathyroidism or HO.
Statistical testing demonstrated a correlation between hyperparathyroidism and HO
(p < 0.001) as well as hyperparathyroidism and vitamin D deficiency (<20 ng/mL).
Direct correlation between HO and low vitamin D was not observed, but
hyperparathyroidism may increase this risk. We believe that those patients who
demonstrate low vitamin D and elevated PTH should be screened for HO in addition
to beginning vitamin supplementation. Initiating early treatment of low vitamin D
to restore therapeutic levels may prevent development of HO.

Langue : ANGLAIS